A presentation from the 2014 Annual Results and Impact Evaluation Workshop for RBF, held in Buenos Aires, Argentina.

1. Impact Evaluation Note
Kenya
Names of team members
H E A LTH R ESU LTS IN NOVATION TRUS T FU N D

2. 1. Background
• Prepilot in 1 sub-county (Nov 2011 – present)
• Scaling up to 21 counties (12 million, 28% of population)
• Arid Semi-Arid Land counties
o Sparsely populated
o Higher level of poverty
o Poorer health indicators
o Limited resources in the health sector (HRH, infrastructure, government
budget, donor support)
• Motivation:
o Equity consideration – where support is most needed
o RBF as part of system reform to improve performance
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4. 2. Description of Intervention
• Supply side RBF
• Pays facilities for delivery of 6 key MNCH indicators
• Program involves both Primary Public and FBO facilities
• Pays for both quantity and quality indicators on quarterly
basis
• 60% of facility payment is staff incentive and 40% is for
facility improvement
• Features may be revised in the design of scale up
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5. 3. Results Chain
o …
INPUTS ACTIVITIES OUTPUTS OUTCOMES
LONGER-TERM
OUTCOMES
HIGHER ORDER
GOALS
o … o … o … o …

6. 4. Primary Research Questions
1. What is the impact of RBF on Service utilization and quality
of care for incentivized services
2. Does explicitly involving CHWs in the program provide
better results than default supply side RBF
3. What factors explain the observed results
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7. Outcome Measures

8. 6. Identification Strategy/ Method
What is the impact of RBF on Service
utilization and quality of care for
incentivized services
Difference-in-differences
21 RBF counties vs 21 non-RBF
counties
Does explicitly involving CHWs in the
program provide better results than
default supply side RBF
RCT
50% RBF only vs. 50% RBF+CHWs
(at sub-county level – 85 subcounties)
What factors explain the observed
results
Qualitative study
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9. 0
10
20
30
40
50
60
70
1 2 3
inst deliveries
Series1 Series2
0
5
10
15
20
25
30
35
40
45
1 2 3
ANC4
Series1 Series2
0
10
20
30
40
50
60
70
80
90
1 2 3
vaccination
Series1 Series2
0
10
20
30
40
50
60
1 2 3
FP
Series1 Series2
Diff-in-diff: 3 year trend in ASAL and non-ASAL counties

10. 7. Sample and Data
1. Surveys
• Facility + household surveys
• Before and after
• Samples from non-RBF, RBF only, RBF + CHWs
2. HMIS data
• all counties except for 5 big and wealthy counties
• 3 years before program + duration of program
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11. 8. Time Frame / Work Plan
• Work plan:
• Form TWG for IE
• Training to sensitize on IE: policy makers, county executive
committee members for health, county health directors and
staff
• Finalize design of intervention and of IE
• Time frame
• Finalize protocol: mid-May
• Baseline: Sept 2014
• Endline: Dec 2016 or June 2017
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